HCBM Contract Analyst

1 week ago

washington, United States State of Washington Full time
DESCRIPTION
This recruitment will remain open until September 28, 2024. The agency reserves the right to make a hiring decision at any time after the initial screening date on September 12, 2024. It is in the applicant's best interest to submit materials as soon as possible.
OIC CAREER OPPORTUNITY
The Office of the Insurance Commissioner's (OIC) Health Care Benefit Manager (HBCM) Unit is seeking a motivated and qualified individual to fill a HCBM Contract Analyst (Functional Program Analyst 3) position. This position is assigned to the Rates, Forms, and Providers Network Division, located in our Tumwater office.
This professional-level position independently performs analytical reviews and evaluations of forms related to health care benefit management contracts and will identify compliance matters with potential recommendations for correction of contract language, thereby assisting health care benefits managers and health carriers meet legal compliance.
What are we looking for?
We are looking for a candidate who is interested in learning about the contract relationships between insurance companies and intermediaries who perform health care benefit management services such as pharmacy benefit management, prior authorization review, and disease management. A successful candidate will enjoy collaborating in a team environment yet be comfortable working independently, be proficient in the specific skills required for the role, able to handle change and adjust to new challenges, competent in identifying issues and devising effective solutions, proactive in taking on tasks and going beyond the minimum requirements, demonstrates reliability, responsibility, and a strong commitment to their work, able to maintain positive working relationships and has effective communication skills, and able to prioritize tasks and meet deadlines effectively.
What's in it for you?
The HCBM is a new unit. The successful candidate would get to be a part of building the team from the ground up and influence its culture. HCBM regulation is new at both the state and federal level and the success candidate will join in this exciting work of regulating entities that directly make decisions about an enrollee's access to health care and prescription medications.
If you're interested in a dynamic career that protects consumers' interests and promotes a healthy business environment in this state, please apply and become part of our dynamic team.
This recruitment may be used to establish a qualified pool of candidates for Functional Program Analyst 3 vacancies in the next sixty days.
This is a Washington General Service position. The monthly salary range for this position is $4,987 - $6,705.
AGENCY PROFILE AND VALUES
The Office of the Insurance Commissioner (OIC) operates under the direction of the state's Insurance Commissioner, a statewide elected official. Our mission is to provide consumer protection and regulation of the state's insurance industry.
With a workforce of approximately 265 employees, we are one of the smaller state agencies in Washington state government and are fortunate to have a stable funding source that does not rely on the state's general fund.
Because we are a small agency, you will truly get a chance to understand the 'big picture' of what we do and why we do it. You will also have a chance to get to know your co-workers.
We value diversity in the workplace. We challenge our employees to continuously improve the way we do business and to meet and exceed the needs of our customers.
To learn more about this agency, we invite you to visit our website at and listen to our employees talk about why they love working here.
BENEFITS OF WORKING FOR OIC
Washington State offers one of the most competitive benefits packages in the nation. We offer a great selection of health and retirement plans , paid leave, and compensation benefits for you and your family.
Additional Benefits:
  • Wellness programs .
  • Dependent care assistance .
  • Washington State Employee Assistance Program .
  • Federal Social Security and Medicare systems.
  • Additional Leave; Leave Sharing , Parental Leave , Family and Medical Leave Act (FMLA) , Leave Without Pay .
  • Deferred Compensation (supplemental retirement plan).
  • Training and development opportunities, including tuition reimbursement.
  • Program for Public Service Loan Forgiveness (if applicable)
  • Free parking at our main office in Tumwater.
  • A stable funding source that does not rely on the state's general fund.
  • The fulfillment of public service.
  • Excellent work-life balance.
  • Flexible work schedules and telework opportunities.
  • Commitment to diversity in the workplace and support one another with respect and trust.
  • Free Thurston County Transit public transportation.

DUTIES
The duties of the position include, but are not limited to:
  • Analyzing and evaluating HCBM contracts using the appropriate checklists, applicable chapters of the RCWs, WACs, and case law.
  • Reporting, consulting, and collaborating with the Functional Program Analyst 4 - Supervisor and Program Manager about issues that restrict a company from issuing compliant contracts in the marketplace or that may impact the marketplace broadly.
  • Communicating issues about compliance concerns with contract provisions and HCBMs and/or their third-party filers.
  • Establishing what is necessary for the contracts to be considered compliant.
  • Conducting research to provide subject matter guidance and information to the appropriate parties.
  • Facilitating resolution with contracting issues or non-compliance.
  • Consulting and discussing contract form provisions, regulations, and case law with OIC staff to ensure consistent and uniform review standards of health care benefit management forms.
QUALIFICATIONS
Required Qualifications:
Six (6) years of experience working in contract writing, management, or regulation through a combination of any of the following:
  • Degree completion (associate degree = 2 years' experience, bachelor's degree = 4 years' experience, and so on); and/or
  • Ensuring compliance with governmental statutory and regulatory requirements; and/or
  • Professional private or public sector work on one or more lines of insurance; and/or
  • Professional private work on one or more of the various healthcare third party services for a health plan; and/or
  • Reviewing legal documents and forms, including contracts.
The degree must be obtained from an accredited college or university whose accreditation is recognized by the U.S. Department of Education and the Council for Higher Education Accreditation (CHEA), or foreign equivalent.
AND
  • Intermediate level Microsoft Office Outlook, Word, and Excel skills.
Preferred/Desired:
  • Experience using the System for Electronic Rate and Form Filing (SERFF) software program.
SUPPLEMENTAL INFORMATION
How to Apply: Applications for this recruitment will be accepted electronically. Please select the large green "apply" button at the top of this announcement. If you have not done so previously, you will need to set up an account profile.
Please provide three (3) professional references on your application. A professional reference is defined as an individual who has been paid to supervise your work and can attest to your work performance, technical skills, and job competencies. If you do not have any or sufficient professional references, please include non-related professionals, such as educators or other professional associates.
The initial screening will be based on the content and completeness of your application and the materials submitted. All information may be verified, and documentation may be required. Your letter of interest should describe how your experience, training and education make you a viable and competitive candidate for this position. Applications with comments such as "see attachments" or "see resume" in the supplemental question responses will be considered incomplete.
General suggestions for creating a good application:
  • Read the job posting very carefully. Find out as much as you can about the position.
  • Make sure you are very diligent in following all the application instructions. Include all requested documentation.
  • Make sure your application and supplemental question responses address how you meet each of the required and desired qualifications.
  • Carefully read each of the supplemental questions and respond completely to each one. Pay attention to each component of the question, providing examples, and thoroughly describing when and where you achieved the experience. Detail the types of work you performed, the work products, etc., to demonstrate 'how'.
  • Specifically include all your work experiences doing the same or similar work, especially if you reference work in these jobs in describing when/where you gained experience or skills.
  • Make sure your application reflects your best writing.
Wage/salary depends on qualifications or state rules of compensation (if currently a state employee).
Contact us: For inquiries about this position, please contact Treese Beckett at .
. click apply for full job details

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